Dépression résistante : les stratégies de changement et d’association de médicaments antidépresseurs

Switching antidepressant medication may be helpful in depressed patients a having no benefit from the initial antidepressant treatment. a Before considering switching strategy, the initial antidepressant a treatment should produce no therapeutic effect after at least 4 weeks of a administration at adequate dosage. a Choosing an antidepressant of pharmacologically distinct profile fails a to consistently demonstrate a significant superiority in terms of a effectiveness over the switching to another antidepressant within the a same pharmacological class. a Augmenting SSRI/SNRIs with mirtazapine/mianserin has become the most a recommended strategy of antidepressant combinations. a Augmenting SSRI with tricyclic drugs is now a less recommended strategy a of antidepressant combinations given the increased risk for the a occurrence of pharmacokinetic drug-drug interactions and adverse a effects.